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<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<link rel="stylesheet" type="text/css" href="../css/main.css">
<title>Документ без названия</title>
</head>

<body>
<form id="registration" >
	<fieldset >
    <span class="zagol"> Область:</span>
    	<select class="form_input" >
        <option >Выберите область</option>
        <option>Донецкая область</option>
        </select>
        <br />
        <span class="zagol"> Город:</span>
        <select class="form_input">
        <option >Выберите город</option>
        <option>Донецк</option>
        </select>
        <br />
        <span class="zagol">Количество бутылок:</span>
        <select class="form_input">
        <option >1</option>
        <option>2</option>
        <option >3</option>
        <option>4</option>
        <option >5</option>
        
        </select>
        
    	
    </fieldset>
</form>
</body>
</html>
